Organization
ROBERT J. BROCKER M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA J EISENBRAUN (OFFICE MANAGER)
(330) 747-9215
Entity
Organization
Contact information
Practice address
1616 COVINGTON ST, YOUNGSTOWN, OH 44510-1244
(330) 747-9215
(330) 747-9248
Mailing address
1616 COVINGTON ST, YOUNGSTOWN, OH 44510-1244
(330) 747-9215
(330) 747-9248
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-053079
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000150690
UNISON
OH
01
—
000000323539
ANTHEM
OH
05
—
0640453
—
OH
01
—
1538350
GATEWAY
OH
01
—
285520211-00
BWC
OH
01
—
285520211008
MEDICAL MUTUAL-YNGS OFF
OH
01
—
285520211009
MEDICAL MUTUAL-WARREN OFF
OH
01
—
4127012
AETNA
OH
01
—
9340971
MEDICARE-YNGS
OH
01
—
9340972
MEDICARE-WARREN
OH
Enumeration date
09/28/2007
Last updated
02/22/2013
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